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May 2012 St@teside

More Exchange Federal Guidance and Establishment Grant Awards

Exchange Guidance

On May 16, 2012, the U.S. Department of Health and Human Services (HHS) released guidance on the partnership and federally facilitated exchange models under the Affordable Care Act (ACA). Of note, the deadline for states to tell HHS whether they plan to run their own exchange or share some core exchange functions (partnership model) with the federal government is November 16, 2012. On that date, states will have to submit an exchange blueprint that shows their readiness to operate a state-based exchange or partner with the federal government. If a state chose to partner with HHS, the state has the option to operate plan management and/or in-person consumer assistance functions (including the Navigator Program). The federal government would then operate eligibility, enrollment, financial management, and the exchange call center.

According to the federally facilitated exchange (FFE) guidance, HHS will be responsible for operating all functions in the exchange, including consulting with stakeholders including Indian tribes, all components of the certification/recertification/decertification process for Qualified Health Plans (QHPs), and eligibility functions. HHS will continue to seek input on FFE policy and operations and has already responded to several frequently asked questions about the process by which it will approve exchange blueprints.

To read a summary of the partnership model and federally facilitated exchange guidance click here.

Level I Exchange Establishment Grant Awards

On May 16, 2012, six states received the newest round of Level I and Level II exchange establishment grants. Level I grants were awarded to Illinois, Nevada, Oregon, South Dakota, and Tennessee. Washington State is the second state to be awarded a Level II grant; $127 million will fund exchange operations for three years. To see a detailed state-by-state breakdown of grant awards and what each state plans to do with its exchange funding click here.